1. Chapter 2
Health Care Systems

2. 2:1 Private Health Care Facilities
Growth—one of the largest and fastest growing industries in the United States
Employment opportunities—employs over 13 million workers in over 200 careers
Expenditures—it is a four-billion-dollar- per-day business and growing
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3. Private Health Care Facilities (continued)
Hospitals-private, religious, nonprofit, government
General, specialty, government, university/college
Long-term care facilities (LTC or LTCF)
Independent living and assisted living
Medical offices-variety of services; large or small
Dental offices
Clinics or satellite centers-colleges, health dept., outpatient, urgent care, surgicenters
Optical centers

4. Private Health Care Facilities (continued)
Emergency care services
Laboratories
Home health care
Hospice agencies
Mental health facilities
Genetic counseling centers
Rehabilitation facilities
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5. Private Health Care Facilities (continued)
Health maintenance organizations (HMOs)-delivery system and insurance
Industrial health care centers or occupational health clinics
School health services

6. 2:2 Government Agencies Government services are tax supported
World Health Organization (WHO)
International agency; sponsored by the United Nations; collects data on serious health issues throughout the world
U.S. Department of Health and Human Services (USDHHS)
National agency dealing with health problems within the U.S.
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7. Government Agencies National Institutes of Health (NIH)
Division of USDHHS; researches various diseases
Centers for Disease Control and Prevention (CDC)
Division of USDHHS; concerned with causes, spread and control of diseases in populations
Food and Drug Administration (FDA)
Federal agency responsible for regulating food and drugs

8. Government Agencies (continued)
Agency for Health Care Policy and Research (AHCPR)
Federal agency; researches quality of healthcare delivery and identifies standards of treatment
Occupational Safety and Health Administration (OSHA)
Establishes and enforces standards protecting workers from job related injuries and illness
Health Departments
Under direction of USDHHS; immunizations

9. 2:3 Voluntary or Nonprofit Agencies
Supported by donations, membership fees, fundraisers and grants
Health services are provided at national, state, and local levels
Examples include the American Cancer Society, March of Dimes, American Red Cross and many more
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10. Voluntary or Nonprofit Agencies (continued)
Organizations focus on specific diseases
Educate the public
Provide special services
Purchase medical equipment
Staffed by many health care workers
and volunteers

11. 2:4 Health Insurance Plans
Health care costs are rising faster than other costs of living
Most people rely on health insurance plans to pay for health care costs
Without insurance, the cost of an illness can become a financial disaster

12. Insurance Terminology
Deductible
Co-insurance
Co-payment

13. Types of Plans Health insurance plans
Health maintenance organization (HMO)
Preferred provider organization (PPO)
Medicare
Medigap
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14. Types of Plans (continued)
Medicaid
The State Children’s Health Insurance Program (SCHIP)
Worker’s Compensation
U.S. government plans for all military personnel and their families
Managed care plans

15. HIPAA Five components Health care access Preventing health care fraud
Tax-related health provisions
Application and enforcement of group health plan requirements
Revenue offsets

16. 2:5 Organizational Structure
Line of authority or chain of command
Indicates areas of responsibility
Goal: most efficient operation of facility
Complex or simple structure determined by size and needs of organization
Sample organizational charts (See Figure 2-4 and 2-5 in text)
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17. Organizational Structure (continued)
The line of authority must be clearly indicated in any organizational structure
Workers must identify and understand their position in the structure
To follow proper channels of communication, workers must take problems, reports, and questions to their immediate supervisor